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NPI Code Detail

MEDICARE: LOVEL PHADAEL RCP

MEDICARE: LOVEL PHADAEL RCP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1227800000XCertified Respiratory Therapist6569GA

General Provider Information

NPI Number : 1457866444
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOVEL PHADAEL RCP
Provider Business Mailing Address
First Line : 2035 MULBERRY LN
Second Line :
City : LITHONIA
State : GA
Zip : 30058-6791
Country : US
Telephone Number : 404-452-9872
Fax Number :
Provider Business Practice Location Address
First Line : 1109 GREEN ST
Second Line :
City : ROSWELL
State : GA
Zip : 30075-3609
Country : US
Telephone Number : 770-998-1802
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2017
Last Update Date : 12/12/2017

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Directions to “ LOVEL PHADAEL RCP” Practice Location

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